Should You Get Antibiotics for that Upper Respiratory Infection?

Should You Get Antibiotics for that Upper Respiratory Infection?

“The waiting is the hardest part.” -- Tom Petty

Over 100 million doctor visits in the US each year result in a prescription for antibiotics. Over a third of those visits are for respiratory infections. A large fraction of the antibiotics prescribed yield absolutely no benefit to the patient. The issue is much more severe than just unnecessary spending on ineff...
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CDC Issues Travel Warning due to Zika Virus

CDC Issues Travel Warning due to Zika Virus

Here’s a fun question to float at your next cocktail party: Which animal bite has killed the greatest number of people? It’s the mosquito. By far. Because mosquitoes transmit malaria, which has killed more people than any other germ. And now, as security guards are coming to remove you from the cocktail party, let me remind you that mosquitoes also spread West Nile Virus, Yellow Fever, Deng...
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Why You Might Want More Blood Pressure Medicine

Why You Might Want More Blood Pressure Medicine

We’ve known for over a generation that using medications to lower high blood pressure can decrease the risk of strokes, heart attacks, and kidney failure. National guidelines have recommended using medications to get the systolic blood pressure (the higher blood pressure number) below 140. So for my whole career a systolic in the 130s would lead to me pat the patient on the back and declare vi...
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The Folly of ICD-10

The Folly of ICD-10

Last week every single physician across the country who bills insurance companies, every hospital, every diagnostic laboratory, every medical facility of any sort that bills Medicare or private insurers switched the set of codes they use to submit diagnosis information to insurance companies from the ninth International Classification of Diseases (ICD-9) to ICD-10. Why? Because the change was ...
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In Defense of Aging

In Defense of Aging

“When nine hundred years old you reach, look as good, you will not.” Jedi Master Yoda

My patients occasionally ask me “do you have something that will make me younger?” Sometimes they’re just joking and want to complain a bit about some indignity of getting older. But frequently they’re serious and would like me to reverse some ravage of time. What I find fascin...
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Best Treatment for Chronic Insomnia is Cognitive Behavioral Therapy

Best Treatment for Chronic Insomnia is Cognitive Behavioral Therapy

I'm having trouble trying to sleep I'm counting sheep but running out As time ticks by… And still I try… -- Brain Stew by Green Day from the album Insomniac

Sleep that knits up the raveled sleave of care, The death of each day’s life, sore labor’s bath, Balm of hurt minds, great nature’s second course, Chief nourisher in lif...

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